Saturday, September 17, 2011


So, as I said in the previous post, I am in surgery.  I am surprised to say that I love the ED part most of all. I mentioned before that I had considered a residency in ED- one focused on Rural medicine that is in NY. I kind of dropped the thought off of my local radar, just because A)money-I need to make some of that green stuff and the sooner the better! and B) thinking that not having the continuity of patient care might limit my enjoyment.

 Nope. Not so. It's actually good- I can care, and deeply care, about getting the patient better enough to get them to the next step of their recovery and that is good. I love the intensity, the need to bring all aspects of my (limited) training to the forepart of my brain, balancing the medicine, surgical aspects in the resus bay. I of course am watching and learning right now. But, my head is swimming with thoughts.  

So, the thought of the residency is back. Strongly. I think it might be great. I think I might like it. And since nothing else has really grabbed me yet during rotations, maybe this is it. Stay tuned.

I also admit feeling like I have not learned nearly enough thus far in my rotations. Not nearly enough. I also admit that I wanted to be at UMMC for many of my rotations. Thus far, I have gotten none of them. Zero. I miss the U, miss the environment that that place provides. There were endless opportunities to learn there- endless. I miss that a lot. I also miss the caring that the U seems to have at the center. I am not seeing that out in the "real" world, and I find that sad.

So help me GOD....If I see/hear of another person slamming a NG tube down someone, without lube, and hurricane spray--forgetting lido-jelly even for a moment as a possible assist-and then wonder why the patient was so miserable and refusing another NG tube, I wish the NG curse on them some day. Because when I asked, I was told "it takes too much time".  Oh boy...If I were not a student, and somehow could mention what I really thought, they'd get an earful.  Say whatever you want, it's the wrong thing to do.

I have seen several surgeries but none of the usual appy, lapchole, bowel obs for me! Nope, was in on a massive lac to the back of the neck where the C-spine was...right... there...and the clot that had formed was as big as a small baby. I kid you not. I have seen orbit repair with screws, plates, mesh. I have seen more I and D's- seemingly the bread and butter of surgery-forget hernias! I have seen an exploration of an orbit from a possible self-inflicted GSW...I'll tell that story at another date. 

I have learned a lot I admit. Most of what I have learned is this: 

  • Who you work with is as important as what you're doing
  • Driving over an hour to work is plain and simple NOT for me
  • I need to be someplace where patient centered care is at the fore-front at all times
  • I need to be someplace where you're striving to always be better, so the patients get better
  • I need to always be able to learn, to push past what I get and enter into areas that I feel lost and need the compass of those wiser than me to survive and thrive
  • Saying I don't know is okay as long as you make sure you will know soon
Till later. I have a hot date with First Aid and Surgery Recall, never mind Casefiles!

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